ATLS FINAL PAPER EXAMPREP COMPLETE
QUESTIONS AND ANSWERS VIEW AHEAD
STUDY SHEET
◉ Which of the following physical findings suggest a cause of
hypotension other than spinal cord injury?
A. Prispism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
E. Ability to flex forearms but not extend them. Answer: D. Presence
of deep tendon reflexes. Spinal shock refers to loss of muscle toe
(flaccidty) and loss of reflexes.
◉ The primary indication for transferring A patient to a higher level
trauma center is:
A. Unavailibility of surgeon or operating staff
B. Multiple system injuries, including severe head injury
C. Resource limitations as determined by the transferring doctor
D. Resource limitations as determined by the hospital administration
E. Widened mediastinum on chest x-ray following blunt trauma.
Answer: C. Resource limitations as determined by the transferring
doctor (MÅ SJEKKES)
,◉ A young man sustains a rifle wound to the mid-abdomen. He is
brought promptly to the ED by prehospital personnel. His skin is cool
and diaphoretic, and his systolic blood pressure is 58mmHg. Warmed
crystalloid fluids are initiated without improvement in his vital signs.
The next, most appropriate, step is to perform:
A. a laparotomy
B. An abdominal CT-scan
C. Diagnostic laparoscopy
D. Abdominal ultrasonography
E. A diagnostic peritoneal lavage. Answer: A. Laparotomy because of
hemodynamic abnormality
◉ A 42-year-old man is trapped from the waist down beneath his
overturned tractor for several hours before medical assistance arrives.
He is awake and alert until just before arriving in the ED. He is now
unconscious and responds only to painful stimuli by moaning. His
pupils are 3mm in diameter and symmetrically reactive to light.
Prehospital personnel indicate that they have not seen the patient
move either of his lower extremities. On examination in the ED, no
movement of his lower extremities are detected, even in response to
painful stimuli. The most likely cause for this finding is:
A. An epidural hematoma
B. A pelvic fracture
C. Central cord syndrome
D. Intracerebral hemorrhage
E. Bilateral compartment syndrome. Answer: MÅ SJEKKES
,◉ A 6-year-o boy is struck by an automobile and brought to the ED.
He is lethargic, but withdraws purposefully from painful stimuli. His
blood pressure is 90mmHg systolic, heart rate 140 beats per minute
and his respiratory rate is 36 breaths per minute. The preferred route
of venous access in this patient is:
A. Percutaneous femoral vein cannulation
B. Cutdown on the saphenous vein at the ankle
C. Intraosseous catheter placement in the proximal tibia
D. Percutaneous peripheral veins in the upper extremities
E. Central venous access via the subclavian or internal jugular vein.
Answer: D. Percutaneous peripheral veins in the upper extremities
◉ A young man sustains a gunshot wound to the abdomen and is
brought promptly to the ED by prehospital personnel. His skin is cool
and diaphoretic, and he is confused. His pulse is thready and his
femoral pulse is only weakly palpable. The definitive treatment in
managing this patient is to:
A. Administer O-negative blood
B. Apply external warming devices
C. Control internal hemorrhage operatively
D. Apply a pneumatic antishock garment (PASG)
E. Infuse large volumes of intravenous crystalloid solutions.. Answer:
C. Control internal hemorrhage operatively
◉ Regarding shock in the child, which of the following is FALSE?
A. Vital signs are age-related
, B. Children have greater physiologic reserves than do adults
C. Tachycardia is the primary physiologic response to hypovolemia
D. The absolute volume of blood loss required to produce shock is the
same as in adults
E. An initial fluid bolus for resuscitation should approximate 20ml/kg
Ringers Lactate. Answer: D. The absolute volume of blood loss
required to produce shock is the same as in adults
◉ A 33-year-old man is struck by a car travelling at 56km/h (35mph).
He has obvious fractures of the left tibia near the knee, pain in the
pelvic area, and severe dyspnea. His heart rate is 182 beats per
minute, and his respiratory rate is 48 breaths per minute with no
breath sounds heard in the left chest. A tension pneumothorax is
relieved by immediate needle decompression and tube thoracostomy.
Subsequently, his heart rate decreases to 144 beats per minute, his
respirartory rate decreases to 36 breaths per minute and his blood
pressure is 81/53 mmHg. Warmed Ringers lactate is adminstered
intravenously. The next priority should be to:
A. Perform external fixation of the pelvis
B. Obtain abdominal and pelvic CT-scans
C. Perform arterial embolization of the pelvic vessel
D. Perform diagnostic peritoneal lavage or FAST
E. Perform a urethrogram and cystogram. Answer: D. Perform
diagnostic peritoneal lavage or FAST
◉ A 42-year-old man, injured in a motor vehicle crash, suffers a
closed head injury, multiple palpable left rib fractures, and bilateral
femur fractures. He is intubated orotracheally without difficulty.
QUESTIONS AND ANSWERS VIEW AHEAD
STUDY SHEET
◉ Which of the following physical findings suggest a cause of
hypotension other than spinal cord injury?
A. Prispism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
E. Ability to flex forearms but not extend them. Answer: D. Presence
of deep tendon reflexes. Spinal shock refers to loss of muscle toe
(flaccidty) and loss of reflexes.
◉ The primary indication for transferring A patient to a higher level
trauma center is:
A. Unavailibility of surgeon or operating staff
B. Multiple system injuries, including severe head injury
C. Resource limitations as determined by the transferring doctor
D. Resource limitations as determined by the hospital administration
E. Widened mediastinum on chest x-ray following blunt trauma.
Answer: C. Resource limitations as determined by the transferring
doctor (MÅ SJEKKES)
,◉ A young man sustains a rifle wound to the mid-abdomen. He is
brought promptly to the ED by prehospital personnel. His skin is cool
and diaphoretic, and his systolic blood pressure is 58mmHg. Warmed
crystalloid fluids are initiated without improvement in his vital signs.
The next, most appropriate, step is to perform:
A. a laparotomy
B. An abdominal CT-scan
C. Diagnostic laparoscopy
D. Abdominal ultrasonography
E. A diagnostic peritoneal lavage. Answer: A. Laparotomy because of
hemodynamic abnormality
◉ A 42-year-old man is trapped from the waist down beneath his
overturned tractor for several hours before medical assistance arrives.
He is awake and alert until just before arriving in the ED. He is now
unconscious and responds only to painful stimuli by moaning. His
pupils are 3mm in diameter and symmetrically reactive to light.
Prehospital personnel indicate that they have not seen the patient
move either of his lower extremities. On examination in the ED, no
movement of his lower extremities are detected, even in response to
painful stimuli. The most likely cause for this finding is:
A. An epidural hematoma
B. A pelvic fracture
C. Central cord syndrome
D. Intracerebral hemorrhage
E. Bilateral compartment syndrome. Answer: MÅ SJEKKES
,◉ A 6-year-o boy is struck by an automobile and brought to the ED.
He is lethargic, but withdraws purposefully from painful stimuli. His
blood pressure is 90mmHg systolic, heart rate 140 beats per minute
and his respiratory rate is 36 breaths per minute. The preferred route
of venous access in this patient is:
A. Percutaneous femoral vein cannulation
B. Cutdown on the saphenous vein at the ankle
C. Intraosseous catheter placement in the proximal tibia
D. Percutaneous peripheral veins in the upper extremities
E. Central venous access via the subclavian or internal jugular vein.
Answer: D. Percutaneous peripheral veins in the upper extremities
◉ A young man sustains a gunshot wound to the abdomen and is
brought promptly to the ED by prehospital personnel. His skin is cool
and diaphoretic, and he is confused. His pulse is thready and his
femoral pulse is only weakly palpable. The definitive treatment in
managing this patient is to:
A. Administer O-negative blood
B. Apply external warming devices
C. Control internal hemorrhage operatively
D. Apply a pneumatic antishock garment (PASG)
E. Infuse large volumes of intravenous crystalloid solutions.. Answer:
C. Control internal hemorrhage operatively
◉ Regarding shock in the child, which of the following is FALSE?
A. Vital signs are age-related
, B. Children have greater physiologic reserves than do adults
C. Tachycardia is the primary physiologic response to hypovolemia
D. The absolute volume of blood loss required to produce shock is the
same as in adults
E. An initial fluid bolus for resuscitation should approximate 20ml/kg
Ringers Lactate. Answer: D. The absolute volume of blood loss
required to produce shock is the same as in adults
◉ A 33-year-old man is struck by a car travelling at 56km/h (35mph).
He has obvious fractures of the left tibia near the knee, pain in the
pelvic area, and severe dyspnea. His heart rate is 182 beats per
minute, and his respiratory rate is 48 breaths per minute with no
breath sounds heard in the left chest. A tension pneumothorax is
relieved by immediate needle decompression and tube thoracostomy.
Subsequently, his heart rate decreases to 144 beats per minute, his
respirartory rate decreases to 36 breaths per minute and his blood
pressure is 81/53 mmHg. Warmed Ringers lactate is adminstered
intravenously. The next priority should be to:
A. Perform external fixation of the pelvis
B. Obtain abdominal and pelvic CT-scans
C. Perform arterial embolization of the pelvic vessel
D. Perform diagnostic peritoneal lavage or FAST
E. Perform a urethrogram and cystogram. Answer: D. Perform
diagnostic peritoneal lavage or FAST
◉ A 42-year-old man, injured in a motor vehicle crash, suffers a
closed head injury, multiple palpable left rib fractures, and bilateral
femur fractures. He is intubated orotracheally without difficulty.
